Repositioning parents in pediatric pain discourse: A communication imperative for inclusive clinical practice

While pediatric pain assessment increasingly emphasizes child self-report, current practices often inadequately integrate parental perspectives, potentially limiting comprehensive pain understanding. This correspondence responds to recent evidence by Lee et al. on parental roles in pediatric pain communication. We argue that existing pain assessment practices, which often inconsistently integrate perspectives from children, parents, and clinicians, can lead to fragmented evaluations. We propose a triangulative communication model that positions parents as epistemic partners, asserting that valuable longitudinal information from parents is often missed in clinical encounters. We advocate for reframing divergent parent-child narratives not as problematic, but as opportunities for a richer and more complete understanding of the pain experience. To operationalize this shift, we propose specific, evidence-based interventions including structured parental assessment tools, provider training on multi-perspective evaluation, and modifications to electronic health records. This paradigmatic shift toward inclusive family engagement holds implications beyond pediatric rheumatology, offering a comprehensive and ethically sound approach to family-centered care while honoring both parental expertise and a child's voice in clinical decision-making.